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Báo cáo y học: "Evaluating the efficacy of sequential biologic therapies for rheumatoid arthritis patients with an inadequate response to tumor necrosis factor-a inhibitor"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học General Psychiatry cung cấp cho các bạn kiến thức về ngành y đề tài: Evaluating the efficacy of sequential biologic therapies for rheumatoid arthritis patients with an inadequate response to tumor necrosis factor-a inhibitors. | Rendas-Baum et al. Arthritis Research Therapy 2011 13 R25 http arthritis-research.eom content 13 1 R25 RESEARCH ARTICLE Open Access Evaluating the efficacy of sequential biologic therapies for rheumatoid arthritis patients with an inadequate response to tumor necrosis factor-a inhibitors 1 2 3 11 2 Regina Rendas-Baum Gene V Wallenstein Tamas Koncz Mark Kosinski Min Yang John Bradley Samuel H Zwillich 2 Abstract Introduction The long-term treatment of rheumatoid arthritis RA most often involves a sequence of different therapies. The response to therapy disease progression and detailed knowledge of the role of different therapies along treatment pathways are key aspects to help physicians identify the best treatment strategy. Thus understanding the effectiveness of different therapeutic sequences is of particular importance in the evaluation of long-term RA treatment strategies. The objective of this study was to systematically review and quantitatively evaluate the relationship between the clinical response to biologic treatments and the number of previous treatments with tumor necrosis factor a TNF-a inhibitors. Methods A systematic search was undertaken to identify published peer-reviewed articles that reported clinical outcomes of biologic treatment among RA patients with an inadequate response to TNF-a inhibitors. Data were systematically abstracted. Efficacy rates were estimated for groups of patients who differed in the number of prior TNF-a inhibitors used. End points included American College of Rheumatology ACR - European League Against Rheumatism EULAR - and Disease Activity Score 28 DAS28 -based response criteria. Results The literature search identified 41 publications of which 28 reported biologic treatment outcomes for RA patients with prior exposure to TNF-a inhibitors. Seven publications reported outcomes obtained in randomized clinical trials while the remaining consisted of observational studies. The likelihood of responding to a subsequent .